Life, death and kidneys: regulation of renal programmed cell death.

Apoptosis plays an integral role during nephrogenesis and is tightly regulated by bcl-2. Transgenic mice manifesting a loss of bcl-2 expression demonstrate fulminant apoptosis of the metanephric blastema during kidney formation leading to renal hypoplasia at birth and multicystic renal disease later in life. In adult kidneys, the rate of apoptosis and level of bcl-2 expression are relatively low. Renal disease can alter the rate of apoptosis and/or elevate bcl-2 expression. The implications of such alterations are discussed.